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Organization

GLEN R DEAN DDS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GLEN ROYDEN DEAN DDS MS (PRESIDENT)
(970) 241-1313
Entity
Organization

Contact information

Practice address
2525 NORTH 8TH STREET, SUITE 105, GRAND JUNCTION, CO 81501-8258
(970) 241-1313
(970) 241-5202
Mailing address
2525 NORTH 8TH STREET, SUITE 105, GRAND JUNCTION, CO 81501-8258
(970) 241-1313
(970) 241-5202

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
104423
CO
1223P0221X
Pediatric Dentistry
1356539922
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04015236
CO
Enumeration date
09/25/2006
Last updated
08/22/2020
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